Feeling exposed? Insights from a new meeting on environmental impacts in autism

Given the historic inattention of the scientific establishment to the environmental contributions to autism, it was nice to see a day-long conference on the topic held this week by a major research center. “Exploring the Environmental Causes of Autism and Learning Disabilities” was put together by the Children’s Center for Environmental Health at the Mount Sinai School of Medicine in New York City. The center is run by Dr. Phil Landrigan, who has been a prominent researcher on the harmful effects of environmental toxicants for decades. He told the incredible story of the harms of lead exposure on children’s cognition and behavior, and how the successful effort to remove leaded gasoline from the market in the 1970s resulted in rising IQ scores and economic gain to the country. I hope this same massive effort will be applied to autism and the chemicals which underlie the increase in its prevalence.

Also of note was the presence at the meeting of Linda Birnbaum. Dr. Birnbaum is the director of the National Institute of Environmental Health Sciences (NIEHS) which holds the autism/environment portfolio at NIH. The Mt. Sinai meeting follows on a workshop held at NIEHS several months ago which explored the role of the environment in autism. Large scientific initiatives in the field fall to the NIH, so without its support, gains will be painfully slow. Hopefully Dr. Birnbaum’s personal involvement signals a heightened interest at NIEHS to look at autism. Although Dr. Birnbaum stated at the conference that her institute spends $30 million on children’s environmental health, at a Senate hearing earlier this year, it was shown that just $8 million of this is for autism specifically.

A few interesting bits of information came out of the conference. One was the definition of “environment” that the insiders use. It covers synthetic chemicals like pesticides, flame retardants and plasticizers; heavy metals like arsenic, lead and mercury; combustion and industrial by-products; diet and nutrients; medications, medical interventions, and substance abuse; infections; the microbiome; heat and radiation; and lifestyle factors. Some may be harmful; others protective. They may operate before conception, during pregnancy or in early life, and some may alter gene expression through epigenetic modifications to chemicals surrounding our genes. Craig Newshaffer, who runs the EARLI study to look at environmental factors among younger autism siblings, referred to the concept of the “exposome”, that is, everything we are exposed to and its effects on health. Dr. Birnbaum’ made the point that health does not equal medicine, and prevention through reduction in chemical exposures is of equal importance to health. Colleen Boyle from the CDC stated that the next prevalence report will be issued in April 2011. We will see if the 1 in 110 number from last year’s report has changed. New research from Korea was unable to confirm increased risk of autism due to parental age or low birth weight, which have been identified as risk factors in Western studies.

The most informative talk was by Dr. Irva Hertz-Picciotto from UC-Davis. She explained how changes in diagnosis do not account for most of the increase in autism rates, and how recent research by their group on mercury and flame retardant blood levels do not address whether these substances are causative for autism because the blood samples were taken years after the autism diagnosis. A paper out this week from UC-Davis found that proximity to traffic air pollution during pregnancy almost doubles the risk of autism. Another paper just accepted by a journal has found higher antibodies to cerebellar tissue in children with autism relative to controls, highlighting the immune component in autism.

Other than these interesting items, the conference covered minimal new ground as far as the science goes. Rather, the points of the meeting seemed to be to make the case that environmental factors research in autism must now be considered mainstream science and to showcase the work being done or about to be done to investigate the issue. Dr. Landrigan made the case for an environmental role by noting that the rate of autism has increased too much to be solely genetic, and that at most, genetics alone will end up explaining 40% of autism cases with the likely percentage much lower.

Autism Speaks provided funding for the conference so that families could attend for free. Alycia Halladay, who runs our environmental science portfolio, noted that environmental factors and how they interact with genetics became one of Autism Speaks 5 priority areas for science in 2010. Autism Speaks also co-funded the NIEHS workshop on the environment earlier this year. Mt. Sinai plans to make video excerpts of the conference available in a few weeks.

I also attended this workshop. See ageofautism.com for my detailed impressions.

Sallie Bernard is correct, the presentation of Dr. Irva Hertz Pinchero was exceptionally good. If Mt Sinai makes this conference available her remarks are very much worth watching for researchers and families alike. The other speakers were not compelling.

Dr. Boyle of the CDC boasted about the “tremendous progress” they have made in autism research over the past 10 yrs. I found this comment, frankly, offensive. It has been families, every step of the way dragging the CDC and the NIH towards addressing autism w/ a meaningful research investment. Progress has been made despite the CDC not because of their paltry efforts. When Dr. Boyle first starting working in autism it affected 1 in 250 American children, now it affects a staggering 1 in 110. This is the CDC’s idea of “tremendous progress?”

With a budget of many hundreds of millions the CD spends just $22 million a year on autism, a national health crisis. However the CDC spends 100x that on H1N1 and even more on the avian flu.

I would have loved to address these issues in person but Dr. Philip Landrigan shouted me down as I attempted to ask a single question after Dr. Boyle’s 45 minute speech.

We can debate the issues and agree to disagree politely. What was totally unacceptable was Dr. Landrigan’s refusal to allow questions from the families helping to sponsor the event.

I also attended this conference. I too was disappointed when I got in line twice to ask a question and none were taken. With due respect however, I would not describe Dr. Landrigan’s refusal to take your question as “shouting you down”. He simply stated there wasn’t time for questions and directed you, me and others to approach the speakers directly. I was able to speak to both Drs. Boyle and Birnbaum during breaks and found them both to be gracious, respectful and quite candid about the lack of research in my own area of interest

It sounds from your post that you are less interested in learning something new or having a question answered than in having a chance to call everyone to task for the pathetic state of the science to date regarding autism research. I couldn’t agree more, but we really didn’t need to spend precious time on that topic. That is a given and not even worthy of “debate” as far as I’m concerned. What I found far more disappointing about the conference was the lack of any real “news” and therepetitive nature of the talks by presenters who, from what I could surmise, were all in each other’s pockets.

Dear Tracy, Because he was speaking to me I think I can fairly categorize Landrigan as impolite. Parents like me are used to being in the minority in mainstream ASD discussions but I have never experienced a total question shut down. Questions are an integral part of these family funded conference- Landrigan was running the show and did not make this a priority at all. Researchers, clinicians and parents were there to learn and discuss. ONLY ONE person learns something by asking questions in private!

Tracy, Please refrain from judging meaning and context of questions I was not allowed to ask. I agree that this was “precious time” all the more reason that Dr. Boyle not speak for so long. Dr. Landrigan could have easily and gently asked her to wind it up after 50 slides and 30 minutes. My point is that federal officials are not the only ones entitled to conference time.

I too wanted to ask about NEW autism research. I wish one of us got the chance to speak.

It seems as though you obtained your grant because you did not mention vaccines as the cause. Thimerosal, a registered pesticide, is in vaccines, along with live viruses grown in the entrails of animals, formaldehyde, aluminum, and other toxic substances. If your child dies right after a vaccine, or stops talking and walking after 30 vaccines like what happened with my friends children, then you have to acknowledge that this is worth looking into. Because someone is able to survive a toxic insult to the body, and others are not, doesn’t make mean it is safe, if anything it calls into the question the safety of doing do. Study long term bio-accumulative effects of getting 68 mandated vaccines. The evidence is starring you right in the face. Because people have more access to information, they are making an informed decision, and it will be the public who will take control of their health choices! So begins the revolution!

Of coarse we are exposed to many toxic insults from multiple sources, they should be eliminated or avoided. Does it do damage and cause genetic mutations? The answer is YES!